Provider Demographics
NPI:1407678337
Name:INFINITUS PATH CORP
Entity type:Organization
Organization Name:INFINITUS PATH CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FARHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-375-8088
Mailing Address - Street 1:19250 BAGLEY RD STE 203
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44130-3347
Mailing Address - Country:US
Mailing Address - Phone:216-333-7769
Mailing Address - Fax:
Practice Address - Street 1:19250 BAGLEY RD STE 203
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44130-3347
Practice Address - Country:US
Practice Address - Phone:216-333-7769
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities